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General NPI Number Information
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NPI Number | 1790134013
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Entity Type | Organization
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Legal Business Name | HEAVENLY HANDS, INC
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 06/07/2016
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Provider Practice Location Address
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Address Line | 1020 PROSPECT AVE 206
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City | WESTBURY
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State | NY
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Zip | 11590-4064
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Country | US
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Telephone | 516-259-6791
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 PROSPECT AVE 206
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City | WESTBURY
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State | NY
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Zip | 11590-4064
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Country | US
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Telephone | 516-259-6791
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HENRIANNA BRADLEY
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Credential | PHD
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Telephone | 516-259-6791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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